Saturday, March 31, 2012

Took all my scrubs (which, yes, include Dora, Curious George, Eeyore, Nemo, and princesses...I love peds!) down from the hangers, folded them neatly, and packed them away.

Well, not really packed them away AWAY, but at least put them on a really high shelf in my closet that I can't reach without a step stool.

Why is this!?

Because I am pretty sure...and extremely hopeful...that yesterday was my LAST day as a staff nurse in the PICU! I have the next week off for a staycation with my family (YEAH!!!!) and then hopefully I will go back to work as PICU APN!

My last day was bittersweet though. Actually mostly bitter because I didn't even get to work in the PICU. I had to float to the neuro/endocrine floor : (

Great! I put in 7 years in the PICU, and to celebrate my last day as a bedside nurse, I get to do the complete opposite of PICU.

While it stunk to not be in my unit...in my home...I learned 2 things.

1.) Parents can be just as CRAZY on general pediatric floors as in the PICU.

and 2.) I didn't realize JUST how stressful the PICU is until I was on a completely different type of unit!

It's amazing how different the regular floors are. SO much more chill, more relaxed!

I don't say that to put the floors down, but the PICU is just different! And apparently I love that stress. Because when I walked back onto the unit at the end of the day, I smiled, took a deep breath, and thought "Ahhh, I'm back home!"

So it's nice to know that despite putting away my scrubs, I won't have to be packing up and moving to a new home. I get to stay in my comfy, cozy....ok, stressful, crazy...but wonderful PICU home!

Let's just hope that all the last minute credentialing paperwork goes through on time. Otherwise, I guess I'll have to get that step stool back out and grab Nemo or George one last time. And hey, I guess that won't be so bad. At least as I unpack my bags (ah-hem, shelf), I am returning home.

Friday, March 23, 2012

There are so many days in the PICU that seem the same. Mundane. A little of this, a little of that, but none of it all that different.

And then there are the patients that come in that make you take a step back and think. Really reflect on life. And how quickly it can pass you by.

As Jon and I have battled fertility issues one prayer we have kept consistent is that we want to get pregnant and have healthy children.

I have a friend who is in the process of adopting children with medical needs, and I applaud her for it immensely. But it is something that I just couldn't do. While I love my work, I want to leave it there. And while there are no guarantees, we still pray for healthy children.

What I am realizing though is that despite many, many people praying for healthy children, anything can happen to these kids as they grow up. And it's not that I think parents stop praying for the health of their children, but life happens.

Take the 6 year old boy who came in yesterday. He has grown up with Type I diabetes his whole life, and had a mother who made sure he took his medication at the right times every day. And yet he got sick. His glucose went sky high.

He went to a small community hospital ED that is not used to dealing with kids. They hadn't seen DKA (diabetic ketoacidosis) like this before, and didn't know how to manage him. So he got sicker.

They did the right thing initially and called us and prepared him for immediate transfer. However, what they failed to do was listen to what our physicians were telling them, or at least carry out instructions in a timely manner.

So this poor kid...compliant with his medications...so brave getting insulin shots every day, is now in the PICU brain dead. Perhaps if the outside hospital would have given that manitol sooner, or started him on an insulin drip like we suggested, none of this would have happened. Or perhaps it would.

But had it not happened, his family would not have to make the decision whether or not to donate his organs. Or how to tell his two older sisters that his cold was actually something much worse. They would not have to go back home and pick out what outfit they would bury their little one in: should they choose something nice that he would look "little man handsome" in, or one of his favorite un-matching "such a boy" outfits.

Whatever they decide, on all of it...the organ donation, how to tell the sisters, what outfit to wear, I know that this family wishes and prays that they didn't have to make it. That they would give anything to go back in time, and perhaps take him into the hospital just a bit sooner.

But despite the saying "hindsight is 20/20" that's not always so. Because even if these parents had taken him into the doctor sooner, this outcome may still have played out. And even if the outside hospital had followed all of our physician's orders to the T, this devastating thing may still have happened.

So as I reflect on my desire, our desire, to have children, I also know how precious life can be. And while I am confident, faithful, that we will have children, my new prayer is that we never take advantage of moments with them. That even when they are running around, snotty noses, acting all crazy, that we can sit back and just take it in.

Maybe reign them in once in awhile, but still, take it all in : )

And know that life is so fleeting, so short. Despite our best efforts to remain youthful we still grow old. And despite the best medicine, sometimes kids die before getting that chance to grow old.

While this is so sad, it is so true. And while I love my job, love the healthcare field, and strongly believe in what we do, we cannot control life.

What a powerful reminder this little boy has been. Thank you for the lessons you have imparted on me in such a short amount of time. May you rest peacefully little one. May you find joy flying with the angels tonight!

Monday, March 19, 2012

This weekend I took care of my usual patient, and thanks to the St. Patrick's Day holiday weekend which equated to a bunch of people calling off so staffing was horrible, I also had another patient.

I'm not Irish (although I did write a family heritage paper my junior year in high school on being Irish...but that was only because I didn't know where my family really came from, and a friend told me while we were in the library to pick up a few books and find a girl who looked like me. So, he flipped open an Irish book and there was a girl that apparently looked just like me. So there ya have it...I was Irish...at least for that paper!)

Anyways, I'm not Irish, so I guess I don't get why St. Patrick's Day is SUCH a BIG...make that HUGE...deal where I live!!! And since it fell on a weekend, people were drunk for 3 days!

Driving home Saturday night was interesting. I not only had to watch out for the usual bad city drivers and crazy bikers who think they are a car but don't care to follow car traffic signals or signs, but also the wasted "I'm not going to look before I stumble into the middle of the busy street" pedestrians. And the one man who fell (passed out?) in the middle of walking across the street...and just stayed there! To which his friends were just laughing at him from the sidewalk!

Yeah, it was interesting. So I guess staying inside the hospital despite the amazing sunny warm weather outside was not all that bad of an idea.

And, despite the fact that my usual patient is usually singled (AKA: one nurse, one patient) because he's so sick and I had another patient because our staffing was so bad, I didn't mind.

My other patient was THE CUTEST girl ever! I seriously want to take this girl home with me. Which may be possible because the mom was there for 35 minutes all weekend. Boo for parents that don't visit their children in the PICU....it seems to be quite the theme lately!

This 10 month old had a nasty case of RSV and was wheezing so loud you could hear her down the hallway, but despite that she was smiley and babbling and oh so cute! I just wanted to cuddle her and kiss her cute little curly head all weekend....while wearing my isolation mask, gown and gloves of course : )

And it was this weekend that I realized (or maybe just remembered since it's been awhile) that while I love working in the PICU with the sickest of the sick, every once in awhile, it's nice to have a patient who is not quite as sick. Someone you can play with and hold and sing to. Someone who smiles back at you and claps her cute chubby little hands when you walk into the room!

I'm sure she won't be in the PICU when I go back to work tomorrow. And I'm sure our staffing will be much better on a non-holiday Tuesday. But, I have to say, despite making it one crazy busy day, I wouldn't mind having the two of them again. It was a good mix of super sick and super cute. And that's a winning combo in my PICU book!

Friday, March 16, 2012

As I was getting ready for our date tonight, I had this flashback to college when I used to get ready for Jon to pick me up on Friday nights! I looked forward to him picking me up ALL week long...and took quite some time to make sure I looked as excited as I felt! For some reason tonight, I had that same feeling!

Which is awesome...because after being married for almost seven years (7!?!) and being together for 10 I still get that feeling! That excited, happy, butterflies feeling on date night!

It won't be a late date since I'm working tomorrow, but I'm looking forward to some good sushi and whatever else Jon has planned!

And speaking of work...I know I haven't blogged in almost 2 weeks. That's partly because I have been taking care of the same patient for the past 14 weeks with no real change. He is still intubated, paralyzed, sedated, and crazy sick.

But its also partly because this patient is the one in which episodes such as this are not all that uncommon anymore. I have been hung up on one other time, yelled at, sworn (sweared?) at, and had to bring this lady down too many times to count.

I'm really not sure WHY I'm still taking care of this patient based on how she treats myself and the other 3 nurses that care for her son.

Well, yes, I do. He is super sick. He may never get better. And if his mother is not willing to spend much time with him, then I can at least give him 40 hours of my time.

So the lack of blogging is mostly in efforts for me to not turn this into a 2 hour long rant about how she treats me despite me taking the absolute best care of her son. I've used the same tactic...silence...with her a few times, and it seems to work.

The self-talk after a really rude comment (eg: I'm sorry I'm taking my anger out on you [don't be deceived that this is an actual apology...wait for it...] you're JUST A NURSE. You can't do anything. The only thing you can do is whatever the doctor tells you.) Yes, this comment happened.

But back to my self-talk: "Despite the fact that you are seething in anger, and you are not JUST a nurse...you ARE A NURSE!!!...turn around and look productive. But most importantly, DO NOT talk for 2 minutes. Because if you do, whatever comes out of your mouth will most likely get you fired!"

And I still have my job...so my silence for 2 minutes seems to work. In that time, I just keep reminding myself that her son is really, really sick. And I can't imagine being in her place. I pray I never have to be. So regardless of how she treats others, I will continue to kill her with my kindness. And pretend that her comments weren't actually said out loud.

So to fully prepare me for a weekend of kindness, I'm off to date night! I may need 2 minutes of silence before I run around all giddy when he comes home from work and gab so fast in excitement that he can't even understand me. On second thought, that will definitely make him laugh (and think I'm slightly crazy) so I think I'll skip it. Plus, I need to save up those silences just in case : )

Thursday, March 1, 2012

I'm not sure why it was so shocking, but I initially gave her the benefit of the doubt and thought her cell just dropped the call, or my hospital phone that's known to do weird things just hung up.

Until I called her back and stated just that, and her response was "Uh- NO! I was done...I said OK!"

Except I wasn't done telling her about her extremely sick son! I had only said one thing...and had about 4 more to go. But apparently she was "done!"

Too bad. You need to be updated on what's going on here. And I'm going to tell you. Even if it means you hang up on me 2 more times. I WILL continue to call you back!

I'm not sure why parents think that taking their anger out of their child's nurse is the best idea. Nurses are the ones they should be the nicest to seeing as we are with their son or daughter 12 hours a day. Those other medical folks? Yeah they usually just pop in and out throughout the course of the day.

But instead, nurses are the ones that get yelled at and take the brunt of the anger even if it truly should be directed at a doctor/nurse practitioner/respiratory therapist etc. And now I am...we are...apparently the ones that get hung up on!

While I recognize that hanging up on me and not wanting to know information about the patient is a coping mechanism (the whole "If I'm not there to see just how sick my son is, and I don't listen to updates, then he truly isn't sick")- as a nurse it is my responsibility to make sure to advocate for the patient.

And if this means calling back a parent despite their anger, their frustration, their attitude, and their hanging up on me...I will do it!

At the end of the day, I will go home and know that while, yes, I got yelled at, I did the absolute best for my patient. And that's what matters. That's what truly counts. That's what nurses do.

Subscribe via email

About Me

I am a new PICU Nurse Practitioner working in the same PICU where I had previously been a bedside nurse for 7 years. This blog is a way for me to document the many fun, memorable, crazy things that come out of taking care of PICU patients. And occasionally I like to throw in some personal documentation of other things that I love- cooking meals with my man, drinking a great glass of wine, decorating my home, thrift shopping, high heel wearing, and traveling. This is my adventure...thank you for stopping in to enjoy the ride!
DISCLAIMER: Any stories in this blog are written to protect patient confidentiality and not violate HIPPA. Names, ages etc. have been changed. If you think that I'm talking about you, I'm not...there are tons of other patients out there that have the exact diagnosis as you, and the same loving/crazy/wonderful/stressed out/amazing/wacko parents to back them up! : )